scholarly journals Efficiency of substitutive renal therapy in the complex intensive care of multiple organ failure in patients with polytrauma

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
S Kravtsov ◽  
A Shatalin ◽  
V Agadzhanyan ◽  
D Skopintsev
Keyword(s):  
Intensive Care ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ

A case of gonococcal necrotising fasciitis

Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 280
Author(s):  
Kudzai Nzenza Kanhutu ◽  
Denis D. Spelman ◽  
Michael D. Weymouth
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Antimicrobial Therapy ◽  
Multiple Organ ◽  
Necrotising Fasciitis ◽  
Gonococcal Infection ◽  
Intensive Care Stay ◽  
Extended Course

This case report details the progress of a patient with severe disseminated gonococcal infection with associated necrotising fasciitis. His admission was punctuated by multiple surgical debridements and a prolonged intensive care stay due to multiple organ failure. An extended course of azithromycin-based antimicrobial therapy achieved a cure and the patient was eventually discharged home after 8 weeks. To our knowledge this is the first such case of histologically and microbiologically confirmed gonococcal necrotising fasciitis.

scholarly journals Severe form of hemolytic-uremic syndrome with multiple organ failure in a child: a case report

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 79
Author(s):  
Dino Mijatovic ◽  
Ana Blagaic ◽  
Zeljko Zupan
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Multiple Organ Failure ◽  
Hemolytic Uremic Syndrome ◽  
Organ Failure ◽  
Hemolytic Anemia ◽  
Multiple Organ ◽  
Uremic Syndrome

Introduction: Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in infants and young children. It is traditionally defined as a triad of acute renal failure, hemolytic anemia and thrombocytopenia that occur within a week after prodromal hemorrhagic enterocolitis. Severe cases can also be presented by acute respiratory distress syndrome (ARDS), toxic megacolon with ileus, pancreatitis, central nervous system (CNS) disorders and multiple organ failure (MOF).Case presentation: A previously healthy 4-year old Caucasian girl developed acute renal failure, thrombocytopenia and hemolytic anemia following a short episode of abdominal pain and bloody diarrhea. In the next week of, what initially appeared as typical HUS, she developed MOF, including ileus, pancreatitis, hepatitis, coma and ARDS, accompanied by hemodynamic instability and extreme leukocytosis. Nonetheless, the girl made a complete recovery after one month of the disease. She was successfully treated in the intensive care unit and significant improvement was noticed after plasmapheresis and continuous veno-venous hemodialysis.Conclusions: Early start of plasmapheresis and meticulous supportive treatment in the intensive care unit, including renal placement therapy, may be the therapy of choice in severe cases of HUS presented by MOF. Monitoring of prognostic factors is important for early performance of appropriate diagnostic and therapeutical interventions.

scholarly journals Use of CT-Based Scoring System in Assessment of Pancreatitis Severity

2019 ◽  
Vol 7 (23) ◽  
pp. 3997-4003
Author(s):  
Madina Ermekova
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Death Rate ◽  
Clinical Laboratory ◽  
Early Stage ◽  
Multiple Organ ◽  
Important Indicator ◽  
Pancreas Necrosis

BACKGROUND: Severity of AP is an important indicator of death rate, playing a crucial role in defining a correct dealing with a patient at his/her initial admission, in deciding on the need to transfer a patient to the intensive care unit. Many studies point out a direct relation between the death rate and the number of affected organs. In light of this, looking for the new criteria of multiple organ failure is still useful in clinical practice. Typically, assessment of multiple organ failure with patients undergoing treatment in the intensive care unit is carried out with the use of various integrated scores based both on clinical laboratory assessment of patient’s condition and on data obtained by advanced imaging methods. However, many scientists point out that the facilities of diagnostic radiology, including in particularly computerised tomography, are not used to the full extent. AIM: We developed a CT score for assessment of pancreatitis severity that takes into consideration not only alterations of the pancreas but also enables evaluation of multiple organ failure with the examined patients. METHODS: We have examined 100 patients with suspected pancreatitis. Among them 30 patients had pancreatitis without alterations of the vital organs; 70 patients had alterations of the vital organs, suffered organ or multiple organ failure and received treatment in the surgery unit and intensive care unit of the Department of Surgical Conditions of Karaganda Medical University. RESULTS: Because of CT results, based on the proposed score, we assessed a degree of pancreas necrosis, analysed the relation between organ failure and degree of pancreas necrosis. Finally, we evaluated the connection between multiple organ failure and the specific failure of one organ and the presence of necrosis and death rate. CONCLUSION: The proposed score for CT-based assessment of pancreatitis severity can be used not only for identification but also for prediction of organ failure at the early stage of pancreatitis to a high accuracy as compared to conventional CT systems for assessment of the condition of patients affected by pancreatitis. It can also be used to differentiate the severity of organ failure and the number of affected organs.

scholarly journals SARS-CoV-2-fertőzéshez társuló többszervi megbetegedés 15 éves fiúban

2021 ◽  
Vol 162 (16) ◽  
pp. 602-607
Author(s):  
Cecília Ormay ◽  
Beáta Onozó ◽  
Réka Fitala ◽  
Károly Halász ◽  
Erzsébet Szakos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiorgan Failure ◽  
Multiple Organ ◽  
Kawasaki Syndrome ◽  
Igg Antibody ◽  
Multisystem Disease ◽  
Diffuse Abdominal Pain ◽  
Antigen Tests

Összefoglaló. Újabb megfigyelések szerint a SARS-CoV-2-fertőzést követően gyermekekben a paediatric inflammatory multisystem syndrome (PIMS) elnevezésű, sokkállapottal szövődött Kawasaki-megbetegedéshez hasonlító, többszervi elégtelenségnek megfelelő tünetegyüttes alakulhat ki. A gyermekek többségében ilyenkor a direkt víruskimutatás már sikertelen, azonban a SARS-CoV-2 ellen képződött antitest igazolhatja a diagnózist. Dolgozatunk célja az egyik első hazai eset ismertetése. Egy 15 éves fiú került gyermek intenzív osztályos felvételre több napon át észlelt magas láz, kesztyű-, zokniszerű exanthema, conjunctivitis, többszervi elégtelenség, szeptikus sokk tüneteivel, akut gyulladásra utaló laboratóriumi eltérésekkel és diffúz hasi panaszokkal. Felvételét megelőzően néhány héttel SARS-CoV-2-fertőzésen esett át. Felvételekor a direkt víruskimutatás sikertelen volt, ám a SARS-CoV-2 elleni antitest vizsgálata pozitív lett. Komplex intenzív terápia mellett állapota stabilizálódott. Az irodalmi ajánlásoknak megfelelően immunglobulin-, acetilszalicilsav- és szteroidkezelésben részesítettük, melynek hatására állapota maradványtünetek nélkül rendeződött. A növekvő esetszámú gyermekkori SARS-CoV-2-fertőzés mellett egyre gyakrabban várható a SARS-CoV-2-fertőzést követő, a Kawasaki-betegség tüneteire emlékeztető PIMS kialakulása. Gyermekekben súlyos szeptikus állapot és többszervi elégtelenség esetén gondolni kell a PIMS lehetőségére, mely esetenként intenzív osztályos ellátást és célzott terápiát igényel. Legjobb tudomásunk szerint a leírásra került beteg a Magyarországon diagnosztizált egyik legkorábbi eset. Orv Hetil. 2021; 162(16): 602–607. Summary. Recently following SARS-CoV-2 infection, a new, multisystem disease (paediatric inflammatory multisystem syndrome, PIMS) with fever was recognized in children with shock and multiorgan failure. On of the first Hungarian cases will be described. A 15-year-old boy was admitted to the Paediatric Intensive Care Unit with persistent high fever, diffuse abdominal pain, septic shock, multiple organ failure, gloves- and socks-shaped cutan exanthema, conjunctivitis and laboratory signs of inflammation. Some weeks preceding his admission, symptoms of mild SARS-CoV-2 infection were revealed. At admission, the SARS-CoV-2 PCR and antigen tests were negative, however, the presence of IgG antibody was shown. Following complex supportive intensive care along with internationally recommended immunoglobulin, aspirin and steroid treatment, the patient was completely cured without any sequalae. In children after SARS-CoV-2 infection, PIMS could occur mimicking Kawasaki syndrome. At this time, in children virus PCR or antigen tests are usually negative already, but the presence of SARS-CoV-2 antibody could prove the preceding disease. Due to the increasing number of SARS-CoV-2 infections, the occurrence of post-SARS-CoV-2 PIMS in childhood is expected to increase. For paediatric patients, in case of severe septic state and multiple organ failure, PIMS should be also considered, which may require intensive care and targeted therapy. As far as we know, the described case is one of the earliest cases of PIMS in Hungary. Orv Hetil. 2021; 162(16): 602–607.

scholarly journals Case Report: Severe form of hemolytic-uremic syndrome with multiple organ failure in a child: a case report

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 79
Author(s):  
Dino Mijatovic ◽  
Ana Blagaic ◽  
Zeljko Zupan
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Case Report ◽  
Multiple Organ Failure ◽  
Hemolytic Uremic Syndrome ◽  
Organ Failure ◽  
Multiple Organ ◽  
Uremic Syndrome

Introduction: Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in infants and young children. It is traditionally defined as a triad of acute renal failure, hemolytic anemia and thrombocytopenia that occur within a week after prodromal hemorrhagic enterocolitis. Severe cases can also be presented by acute respiratory distress syndrome (ARDS), toxic megacolon with ileus, pancreatitis, central nervous system (CNS) disorders and multiple organ failure (MOF).Case presentation: A previously healthy 4-year old Caucasian girl developed acute renal failure, thrombocytopenia and hemolytic anemia following a short episode of abdominal pain and bloody diarrhea. By the end of the first week the diagnosis of the typical HUS was established. During the second week the disease progressed into MOF that included ileus, pancreatitis, hepatitis, coma and ARDS, accompanied by hemodynamic instability and extreme leukocytosis. Nonetheless, the girl made a complete recovery after one month of the disease. She was successfully treated in the intensive care unit and significant improvement was noticed after plasmapheresis and continuous veno-venous hemodialysis.Conclusions: Early start of plasmapheresis and meticulous supportive treatment in the intensive care unit, including renal placement therapy, may be the therapy of choice in severe cases of HUS presented by MOF. Monitoring of prognostic factors is important for early performance of appropriate diagnostic and therapeutical interventions.

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